Which Breast Pump should you Choose?

With so many breast pumps on the market, it’s difficult to choose which one to buy. Medical grade pumps, standard double electric pumps and hands-free pumps are the most commonly used. Let’s discuss the different kinds of breast pumps and which ones I recommend, based on different situations.

If you have a baby who was premature and/or a NICU baby and you’re separated for long periods of time, a medical grade pump is probably your best choice. The medical grade pump such as the Medela Symphony is the Ferrari of breast pumps and can help get your milk supply established or help to increase it. The stimulation you get from this type of pump is superior to all the pumps on the market. That’s why it’s a very expensive pump and deemed ‘medical grade’. If you need a medical grade pump, often times insurance will cover the cost to rent it with a prescription from your doctor. Or, you can rent it yourself from a medical supply company.

Standard double electric pumps such as the Spectra, Medela, Motiff, Lansinoh, etc. are the most popular pumps among moms however, they are not all created equal. Most of these pumps are covered by insurance. Be aware, some brands such as the Medela have ‘insurance versions’ of the pump which are much less efficient and sturdy than if you were to buy the same pump in the store. It’s important to know that some double electric pumps just don’t have the ability to stimulate a letdown as well as others. I always recommend the Spectra. I’ve used the Spectra myself (after trying other brands) and I’ve had countless clients who have also used it. The Spectra is far better than any other standard double electric pump on the market right now. It’s quiet, gentle, it has multiple settings, and it tends to be the best at mimicking how a baby suckles and removes milk. I’m not sponsored by Spectra, I’m just sharing my personal and professional opinion. If your insurance covers a Spectra, get this brand. The Spectra insurance version is the same as store bought. The Medela is a very popular pump. I’m not quick to recommend the Medela because it’s loud, it can be rough on the nipples, the insurance version is not as efficient as the store bought one and the motor tends to burn out quicker than others. Don’t get me wrong, I love Medela products and use them often but I’m not a huge fan of their breast pump. I do however, know many moms who use the Medela with no issues and love it.

The other types of pumps on the market that are quickly gaining popularity are the hands free pumps such as the Freemie or the Willow. I love that these pumps can be worn relatively discreetly and they allow a mom to be completely hands free and mobile. I recommend these pumps for second time mamas who only occasionally pump or need to stimulate their breasts a little more after nursing their baby. There’s nothing better than being able to pump milk while chasing around a toddler. However, for some moms, the hands free pumps are not good at increasing or even maintaining milk supply. They don’t have the ‘baby power’ to replace nursing sessions on a regular basis. So if you’re a mom with a history of low milk supply, if you’re going back to work full time or you need to exclusively pump, the hands free pumps are not ideal. Another downside to the hands free pumps are the cost! They are very expensive and it’s not recommended to buy them used because of possible contamination. Not to mention all of the parts and assembling required to use the hands free pump.

If you plan to pump whether it’s occasional or more regularly, ask an LC to help you choose which pump would be best for you and your situation. If we know more about your history and your pumping plans, we can help you choose the best breast pump for you.

A Good Latch

A good latch is everything! Here are a few great things I notice about the way this baby is nursing. Take a look at how wide this baby’s mouth is open. Baby should open wide while latching, similar to the gape of a yawn. This will ensure the baby gets enough of the breast tissue in her mouth, far back to the soft palate where it needs to be. This enables optimal milk transfer. Notice how close the nose and chin are to the breast. Pull your baby in close to you while feeding. This ‘hug’ will help baby maintain that deep latch while nursing. The baby’s body in this pic is in alignment, ear/shoulder/hip, all aligned while facing tummy to tummy with mom. This is important for baby’s comfort and ease of swallowing at the breast. The baby has her hand on mom’s breast. This allows her to be snuggled in close, tummy to tummy without hands or arms in the way. Sometimes you will notice your baby will massage your breast with their hand. This is how they try to initiate your milk to letdown. Be sure to practice a good latch each nursing session to optimize milk transfer and keep your nipples safe from soreness or damage. Can’t get a good latch? Make an appointment with an LC sooner than later. You will be happy you did.

Managing Nighttime Nursing

Exhausted new mamas… I see you. Your newborn baby is waking up every two hours at night to nurse. Your partner wants to help but you haven’t introduced the breast pump and bottle into your routine yet. Your baby’s only food source is you! One of the most common questions I get is ‘How on earth can I get enough sleep at night!?’ Here are my top 5 strategies for managing night time sleep when you’re a breastfeeding mom. There are many more but the following 5 are the most successful tips I’ve known to work for my family and my clients.

1. Don’t let your baby go more than 2 hours during the day without nursing. The more calories they consume in the daytime, the less they will require at night. Be sure to nurse baby right before and right after daytime naps to be sure you stick with this frequent nursing routine.

2. When you’re ready to put baby down for the night, make sure the room is set up for baby’s comfort. This includes white noise, the perfect temperature (68-72 degrees), good airflow (light fan or air purifier), a dark or very dim lit room, and mama or something with her scent nearby.

3. Try placing a mattress on the floor for baby to sleep on, next to the bed you sleep on. When baby wakes at night, you can nurse him/her in your bed or their bed in the side lying position. This should allow minimal waking while both your needs are met (nursing, sleeping).

4. As stated above, nurse baby frequently throughout the day (every 2 hours) and make sure you get in a good nursing session right before bed. When baby wakes for the first nighttime feeding, have your partner bring the baby to you in bed and nurse in the side lying position. Your partner can also be in charge of other needs before after the feeding. Diaper change, rocking, burping, etc. while you continue to stay in a restful state.

5. Follow the ‘safe sleep 7’ and let your baby sleep in your bed. Your baby will surely wake less with you next to them and when they do wake, you can nurse and both go back to sleep without getting up. You’re not creating bad habits or spoiling your baby. You’re meeting both of your needs and surviving the night in the easiest way possible.

It’s important to know that sleeping through the night is a milestone that every baby whether they’re breastfed formula fed, will reach at their own time. Embrace the chaos (and the coffee) and hang in there.

Back to Work for the Breastfeeding Mom

Breastfeeding is finally becoming easier, you’re in a manageable routine, your baby is finally falling into a more predictable feeding pattern and now you have to prepare to go back to work. Sigh. The thought of leaving your baby can cause a lot stress, especially when it’s time to begin preparing for your absence. How and when do you start building a breastmilk stash for baby before you start working? How do you introduce a bottle to a breastfed baby? How do you determine how much milk your baby will need when you’re at work? What should your pump schedule look like when you’re away from your baby? How should you store your milk? Will your baby be willing to take a bottle while you’re gone and breastfeed when you’re together? These are some of the common key questions I hear from working moms and I’ll answer them for you!

How do you begin building a breast milk stash for your baby before you start working?

Believe it or not, you don’t need a huge stash of breast milk saved up before you start work. You really only need 1 days worth of milk saved for your first day back. When you’re at work, you will pump the milk you need for the next work day and so on. Friday’s pumped milk will become baby’s bottle feedings for Monday. If you nurse your baby right before you leave for work and immediately upon return, you will need to leave baby approximately 1-1.5 oz of breastmilk per hour you are separated. With this in mind, you can calculate how much milk you will need saved before that first day back to work. Start collecting milk a minimum of 2 weeks before you start back to work. You can collect milk by adding in pumping sessions after a few nursing sessions throughout the day, especially in the late evening or early morning when your prolactin is the highest. Some moms can collect the amount of milk they need just by using the Haakka on the opposite breast baby is feeding on. Don’t be discouraged if you’re only getting 1/2oz-2oz of milk per pumping session. This is normal! Keep pumping and collecting and eventually you can accumulate the milk you need for your first day back to work.

How do you introduce a bottle to a breastfed baby?

Ideally you’ve started introducing the bottle to your baby around 4-6 weeks old so it’s not completely foreign to them. If you haven’t, that’s ok, start introducing it now (or at least 2 weeks) before you return to work. Get a slow flow nipple for the bottle you’re using and start trying to feed your baby small amounts with the bottle about 1 hour after a nursing session. Always use the paced feeding method when offering the bottle. If you’re unsure what paced feeding is, check out my past blog or look up paced bottle feeding information from La Leche League or KellyMom.

How do you determine how much milk your baby will need when you’re at work?

Plan to nurse your baby right before you leave for work and as soon as you return from work. That way you won’t have to pump as soon as you get to work and right before you leave work. You will need to leave your baby approximately 1-1.5oz of breastmilk per hour of separation.

What should your pump schedule look like when you’re away from your baby?

Ideally Pumping should mimic your baby’s feeding pattern while you’re at work. Since this is not always an option, you can plan to pump at least every 3 hours for 15-20 minutes while you’re away from your baby. Talk to your boss ahead of time and secure a designated quiet place to pump to save time and added stress.

How should you store your milk?

Refrigerate your expressed milk as soon as possible if you don’t plan to feed it to your baby within 4 hours. If you don’t have a refrigerator at work, use ice packs in a cooler to keep the milk cold until you get home. Once you’re home, refrigerate milk you plan to use within 5 days and freeze milk if you plan to use it after 5 days.

Will your baby be willing to take a bottle while you’re gone and breastfeed when you’re together?

Every baby is different! Some babies will find it hard to toggle back and forth from bottle to breast and some transition perfectly. An important step to take to ensure baby comes back to the breast is to make sure your caregiver uses the paced feeding method when bottle feeding. Nurse your baby just before you leave for work and as soon as you arrive home. Plan for extra skin to skin time when you’re together and nurse whenever your baby wants. You might find baby wants to nurse more at night to make up for the time missed with you during the day. If your baby is having a hard time taking a bottle when you’re at work, check out my blog about bottle refusal.

Going back to work can cause a lot of stress for a breastfeeding mama. Keep in mind that you and your baby will eventually fall into a routine and the transitions from breast to bottle will become easier. If you’re having trouble with anything mentioned in this blog, please reach out to an LC! We can help you make a smooth transition from home to work with a care plan tailored just for you and your baby.

Pacifier for the Breastfed Baby?

There are a lot of opinions about pacifiers for breastfeeding babies and some experts will recommend limiting their use or not introducing them at all. Let’s look at the reasoning behind this recommendation. Pacifiers or ‘dummies’ as they call them in the UK are essentially an artificial nipple made for babies to ‘pacify’ them until their next feeding. When we use a pacifier for our breastfeeding baby, especially in the early weeks, we can miss important feeding cues that our baby uses to let us know they’re ready to nurse. Some of these cues are putting their hand to their mouth, sticking their tongue out, mouthing, etc. and are impossible for a baby to do while sucking on a pacifier. Pacifiers also decrease the amount of time our baby suckles at the breast which can sometimes lead to poor weight gain in baby and/or decreased milk supply for mom. When we allow our baby to nurse and/or suckle at the breast often in the early weeks, they are essentially establishing mothers milk supply. Pacifiers can really limit this special communication between the baby and the breast and because of this, babies who receive pacifiers are more likely to wean from the breast earlier than babies who don’t use one.

Pacifiers certainly do have their place and can be beneficial in certain situations, even for babies who are or will be breastfeeding. Pacifiers can help premature infants practice and strengthen their sucking reflex and can help tube fed babies associate sucking with food when given simultaneously. Pacifiers also may help reduce the risk of SIDS. Although, breastfeeding alone already decreases the risk of SIDS by more than 50% so this benefit is more for bottle fed babies. Pacifiers are great when used to soothe babies during medical procedures or even in less serious situations like riding in the car or passing the time while mom runs an errand.

As an LC, I’m often asked if and when a pacifier can be introduced to a baby. I typically ask moms to try and wait at least 4-6 weeks until their milk supply is established first. It’s also important that the baby’s weight gain has been sufficient before offering a pacifier. Make sure you are offering the breast first and only allowing the baby have the pacifier for short intervals such as on car rides, in a store, or in places when nursing isn’t possible. As a mom, you make the best decisions for you and your unique situation and if that includes using an occasional pacifier for your baby, then so be it! However, if you and your baby have been fine getting along without a pacifier so far, save yourself potential problems down the road and just don’t even offer one.

Breast Storage Capacity

There are a lot of factors that can influence the amount of times your baby needs to nurse in 24 hours. One of these factors is your breast storage capacity. If you have a large storage capacity, your baby may be able to consume 5+ ounces of milk per feeding, keeping them feeling full longer. If you have a small storage capacity, your baby might only consume 2 ounces or less per feeding and will need to nurse more frequently throughout the day and night to get the calories they need.

A small or large breast storage capacity depends on the maximum volume of the mothers grandular tissue. Not to be confused with fatty tissue of the breast which makes our breasts appear physically larger or smaller. A woman with large breasts may have smaller grandular tissue capacity than a woman with smaller breasts and vice versa.

The good news is, no matter what your grandular tissue storage capacity may be, most mothers have the ability to produce a full milk supply for their baby. If your breast storage capacity is small, your baby will want to nurse more often throughout the day and night to consume the amount of daily calories they need. If you have a large storage capacity, your baby may want to nurse less during the day or sleep long blocks at night because they are consuming larger amounts of milk per nursing session.

The benefit to having a smaller milk storage capacity is that your baby is more likely to empty your breasts at each feeding. This ensures that your baby is consuming the higher fat milk or hindmilk that is available when the breasts are on the empty side. The emptier the breast, the higher the milk fat content. The more full the breast is, the lower the milk fat content.

You might have already guessed the benefit to a higher breast milk storage capacity. Longer intervals between feedings and possibly longer stretches of sleep at night! However, some moms with a larger storage capacity can be more susceptible to clogged ducts, mastitis and their babies may experience more digestive discomfort especially in the early weeks.

It’s important to remember that whatever your breast storage capacity is, you likely have the ability to make enough milk for your baby. Small glass or large glass, which one does your body offer your baby?

When to seek the help of a Lactation Specialist

Are you wondering if you should seek the help of a lactation consultant? Every mothers’ breastfeeding journey is beautifully unique and may come with more challenges than you were expecting. I am trained to help you navigate through the issues that come up and find solutions that work for you and your baby. Here are a few common reasons a breastfeeding mother reaches out for lactation support.

-You get home from the hospital and your milk comes in. You want to make sure your baby is gaining well and emptying your breasts efficiently.

-Your milk came in late and/or your baby dropped a significant amount of weight after birth.

-Feeding is becoming difficult and your baby is fussy at the breast.

-Your baby feeds too little or too often and you want to know how much milk they are transferring in a nursing session.

-You’re experiencing nipple pain, soreness or damage.

-You have a fast letdown and you want to help baby manage the flow.

-Your baby spits up a lot and you want to know if there is something you can do to manage it.

-You have too much or to little milk and need your supply to match baby’s needs.

-You need advice on when and if you should pump. Do your flanges fit correctly?

-You’re unsure if you should be nursing, pumping, hand expressing, using the Haakka or all the above.

-You’re going back to work and you need a pump/nursing plan and advice.

-You feel as if you need a professional to evaluate and reassure you that things are going well with breastfeeding.

-You’re feeling overwhelmed and need a care plan for feeding, sleeping and taking time for yourself.

-You’re wondering if your baby might be allergic to something in your diet.

-Your baby is colicky and you’re wondering what you can do about it.

-Your baby has oral ties and you need breastfeeding support before or after a revision.

-You suffer from clogged ducts or mastitis.

-Your breasts are always sore and uncomfortable and you want to figure out the root of the problem.

-You want to wean or begin solids and you don’t know where to start.

You don’t need to try to work through breastfeeding issues on your own! I’m here to help. Contact me via PM, text, call or email. Feel free to join my breastfeeding support FB group to connect with other local bf mothers. We’re in this together! https://www.facebook.com/groups/442088640517440/?ref=share

For reviews, services and my affordable pricing, visit my FB @loveandlactation or website http://www.loveandlactationnc.com

My Top 10 Breastfeeding Support Supplements

Moms always ask me what supplements they should be taking while breastfeeding. If you are eating a well balanced diet and things are going well with breastfeeding, you don’t have to add additional supplements to your diet. However, there may be issues you’re experiencing that might justify adding certain supplements to your breastfeeding care plan.

Moms most often ask about supplements to increase their milk supply. Interestingly enough, only two of the supplements I commonly recommend are considered to be galactagogues (food/drinks thought to increase milk supply). For the most part, galactagogues aren’t successful for EVERY mom, they can be expensive and some are even thought to decrease milk supply. There is no supplement that works better than extra nursing/milk expression to increase milk supply.

When I recommend supplements, they are only in addition to the extensive care plan we’ve come up in our lactation session and they act as extra reinforcement. The 10 supplements I love best are thought to help with colic, digestive discomfort, clogged ducts, thrush, spit up, energy stores, etc.

If you’re interested in trying any of the top 10 breastfeeding supplements I mention below, you should definitely run it by your doctor first just to make sure it’s safe for you and/or your baby.

-Probiotics- For mom AND baby. I can’t stress how important gut health is for everyone, breastfeeding or not! Luckily, breast milk is a natural probiotic. However, if your baby experiences reflux, spit up, gas, colic, thrush, etc. you may want to add in an additional probiotic supplement for both of you to see if you notice an improvement in symptoms.

-Digestive Enzymes-For mom. DI’s breaks down the larger protein molecules in moms diet making it even easier for baby to break down. They can help with digestion, gas and can help calm fussiness.

-Sunflower Lecithin- For mom. Sunflower Lecithin is a fat emulsifier and it helps to prevent clogged ducts and mastitis. It’s much more successful when used as a preventative rather than a treatment.

-Calcium and Magnesium- For mom. Our bodies extract calcium from our bones when we breastfeed so it’s important to add extra calcium to our diet via food or supplement. Magnesium helps with calcium absorption and also helps mom recover from birth and sleep better at night. *It’s important to note that after weaning, our bodies recover from the calcium loss whether we supplement or not!

-Omega 3- For mom. Omegas-3 is great for better mood (may help mom release more oxytocin), circulation, and brain health.

-Vitamin D-For mom and baby. Vitamin D is not easily passed through breast milk. Mom should take 6,400 IU of it to make sure baby gets the recommended dose via her milk or supplement baby with 400 IU. Whether you’re supplementing or not, get outside and soak up some natural Vit D from the sun each day!

-Cumin & Fennel- For mom. These herbs are anti-inflammatory and can provide digestive support for mom and baby via her milk. They make cumin and fennel teas or you can add these yummy herbs to your food!

-Morniga- For mom. Morniga has been associated with an increased milk supply in mothers who consume it. This is the only galactagogue I like to recommend because even if it doesn’t increase a mamas milk supply, it can at least help boost her immune system, assist with sensitivity to allergies and provide an overall nutrient boost.

-Ginger- For mom. Ginger is an anti-inflammatory, anti nausea, immune booster and has been thought to increase milk supply. It also is great to use in place of coffee/caffeine in the morning for a boost of energy.

Breast Pumping Tips

Breast pumps are useful when you need to replace nursing sessions, maintain your milk supply and collect or save milk. They can also be used after nursing sessions to encourage your body to make more milk, beyond what your baby has removed from the breasts. How do you make sure your pumping sessions are efficient and effective at collecting the amount of milk you need for your baby? Try these tips to make the most of your pumping sessions.

-Plan ahead! Set up to pump in a quiet, comfortable, stress free environment.
-Make sure your pump parts are in good condition. Replace pump parts after 3 months of continuous use or even earlier if you notice the parts have tears, scratches or appear worn. Inspect the parts before each pump session.
-Make sure your pump flanges are comfortable and fit properly.
-If you cannot be with your baby while you pump, have a piece of your baby’s clothing handy with her scent, look at pictures of your baby and listen to videos of her noises. This will help your body release the oxytocin it needs to trigger a letdown. If your baby is near, you can help release the oxytocin by touching your baby, interacting and/or just adoring her!
-Close your eyes and visualize milk flowing abundantly from a waterfall, stream, faucet, etc. while you pump. It is also helpful to listen to sounds of streams, pouring rain or waterfalls. (This tip worked wonders for me!)
-Use hands on pumping. Massage your breasts before you pump and use breast compressions while you are pumping. Hands on pumping is easiest to do while wearing a comfortable fitting pump bra.
-Let gravity do its job by leaning forward every few minutes while using breast compressions to effectively drain the breasts. (Don’t lean too far forward or milk can drip out of the bottles!)
-Make sure you are using a comfortable setting on your pump. A higher suction does not mean you will get more milk. Pumping should be comfortable and not painful. Start at a low suction and work your way up until you find the setting that works best for you.
-Cover the collection bottles so you don’t watch the milk accumulating. It can be discouraging and affect your letdown if you stare at the bottles.
-Save your favorite snack or treat to enjoy during your pumping sessions.
-Find a comfortable pumping bra that fits properly and is not too tight. Buy 2 of the one you love so you have a backup.

Pumping can be a great tool to use when you must be away from your baby. If you are pumping to increase your milk supply, replace nursing sessions on a regular basis or pump exclusively, it is important that you use a double electric pump. If your baby is in the NICU and/or born prematurely, it is recommended to use a hospital grade pump until you and your baby reunite with regular skin to skin and nursing sessions. Pumping can take practice before you begin to see a typical milk output. Keep trying, use the tips mentioned above and eventually you and your body will begin to respond positively to the pump. And remember, a pump is not as effective as a nursing baby is at removing milk! Therefore, the amount of milk you pump is not a good indication of how much your baby removes from the breasts while nursing. Happy Pumping!

Montgomery Glands

Montgomery glands are the little tiny bumps around your areola that become more prominent during pregnancy and lactation. I’ll never forget a client of mine noticing hers early postpartum and asking me if she’s had a reaction to breastfeeding. I was happy to tell her all of the amazing things these little bumps are designed for!

Montgomery glands are a mothers very own sanitizing factory during lactation! They secrete an antibacterial oil that helps to keep mothers nipples free from harmful bacteria. They protect beneficial bacteria that can nurture a healthy gut for your baby when they nurse. Montgomery glands help lubricate mothers nipples to help protect them from dryness and cracking between nursing sessions.

The oils that the Montgomery glands secrete during lactation have a scent that attracts the baby to mothers nipples for milk. The scent makes it easier for your baby to find her food source. If you allow a newborn baby to lye on your chest, the scent from your Montgomery glands and the color of your areola’s will help lead your baby to the milk.

Montgomery glands keep mothers nipples clean and safe for baby without the need for extra washing or wiping before nursing or pumping sessions. Your daily shower is enough to keep that area clean for your nursling and allow the Montgomery glands to do their job secreting that natural scent for your baby. Other than your daily (or every other day) shower, let your magical Montgomery glands go to work for you keeping your nipples clean, healthy and ready for nursing!